Poor Predictive Value of Inflammatory Back Pain in Identifying Axial Involvement in Psoriatic Arthritis

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Poor Predictive Value of Inflammatory Back Pain in Identifying Axial Involvement in Psoriatic Arthritis

According to a study published in the 'Annals of the Rheumatic Diseases' Journal, the Rheumatologist-judged inflammatory back pain (IBP) or the criteria for IBP made for ankylosing spondylitis may not work well in identifying the axial involvement in Psoriatic Arthritis (PsA).

The authors of this study investigated the agreement between rheumatologist-judged IBP and criteria defining IBP in patients with psoriatic arthritis (PsA) and predictive value of IBP in recognizing the axial involvement in PsA.

The kappa coefficient was used to explore the agreement between rheumatologist judgment of IBP and IBP criteria (Calin, Rudwaleit, and Assessment of Spondyloarthritis International Society) utilizing the prospectively collected data. Yap KS et al. also determined the sensitivity, specificity and likelihood ratios of the presence of back pain, rheumatologist-judged IBP and the three IBP criteria for detecting axial PsA (AxPsA). Lastly, the clinical and genetic markers in patients with PsA were compared with axial radiological changes with and without back pain.

All in all, 171 patients (52% male) with a mean age 46.6 years were recognized out of which 97 56.13%) patients reported chronic back pain and 65 patients (38.01%) had IBP. Fifty-four (32%) patients had evidence of radiological change in the spine. The rheumatologist judgment of IBP and IBP criteria were in accordance as they were the highest for the Calin criteria (0.70). A favorable likelihood ratio for the presence of radiological axial involvement was the highest for Rudwaleit criteria (2.17).

There were no differences between patients with AxPsA with or without back pain. The only exception was the higher Bath Ankylosing Spondylitis Disease Activity Index and lower incidence of human leucocyte antigen-B*38 in those with back pain.

Source

Ann Rheum Dis. 2018 Aug 4

Link to the source

https://www.ncbi.nlm.nih.gov/pubmed/30077991

Original title of the article

Back pain in psoriatic arthritis: defining prevalence, characteristics and performance of inflammatory back pain criteria in psoriatic arthritis

Authors

Yap KS et al.

SearchTags: 
Exploratory, Back pain, Psoriatic arthritis, Back, Chronic, Kappa coefficient, Calin criteria (0.70), Rudwaleit criteria (2.17), Bath Ankylosing Spondylitis Disease Activity Index
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